-Identify the fiscal year cycle (for example, January 1 through December 31) Not all hospitals are on the same cycle. – Does the process start all at the same time or does the cycle start with capital budget, then operational budget then labor? If so, what is the time frame and sequence for each? – Remember there are usually at least three types of budget processes: capital, operational and labor. They can occur at the same time but usually not since each goes in a separate track and must be reviewed by different parties. – Do not forget to tell the reader who provides the final approval (Board of Trustees, upper corporation, Chief Executive Officer, etc) 2. Describe how it is developed, what is the process, and who is involved in the development? -Identify the role of the manager and the staff in the budget. Many times the manager needs to talk with the key physicians to see if they need something on the unit for their practice. This is particularly true with the surgical department. Many of the physician needs/requests for surgery involve capital expenditures. – To purchase capital items then, what is the process? It may involve having three quotes, completion of a capital form which includes construction needs and final approval by a board of trustees. – Operational budgets are usually completed at the departmental level and completed by the manager after a review of last year expenses and adding an inflationary rate. Ask the superior/director who sets the inflationary rate and for what items. – Labor budgets are usually completed by the manager with review of hours per patient day, staff needs, performance appraisal raises, overtime, etc. Consider mentioning items in this type of budget. There is no need to go into detail. 3. Describe nurse manager accountability for the department budget.

Describe the process. -Ask the director/superior what tools are available to the manager to help monitor the budget compliance. Do they need to submit a report of variances biweekly or monthly? Do they have to present at a meeting? Is there something different for the manager to do regarding labor issues and staffing accountability? 4. Describe the type of budgeting used and provide rationale (Flexible budgeting, incremental or zero-based). Describe the Case Mix Index for the unit and or organization. -Remember when explaining the type of budgeting, make sure to say how that works for that unit. For example, the emergency department is typically a flexible budget with the need to justify variances in “encounters”. These variances (up or down) will help to explain why medical surgical supplies, office supplies, dietary needs, etc are up or down. 5. Discuss and identify with the manager two key areas that need of improvement. -Be specific with these areas. Remember to explain more on these areas in #6 and #7. Have the manager go over specific frustrations with compliance to budget that the staff could help problem solve. 6. Discuss how these improvements can be accomplished. -The point of the paper is to take the information learned from in the interview with the director/superior and show a leadership approach to making a positive change in the financial picture of the unit. 7. Describe the role of the nursing staff to help meet those improvements. -This is the time to share easy concrete suggestions for staff to be more aware of the financial needs in the department and their impact on the budget. 8. The scholarly paper should be in narrative format of not more than four (4) pages excluding the title page, reference page, and appendices. 9. Include an introductory paragraph, purpose statement, and a conclusion. 10. Include level 1 and level 2 headings to organize the paper. 11. Write the paper in third person, not first person (meaning do not use ‘we’ or ‘I’) and in a scholarly manner. To clarify: I, we, you, me, our may not be used. In addition, describing yourself as the researcher or the author should not be used. 12. Include a minimum of two (2) professional peer-reviewed scholarly journal references to support the paper (review in Ulrich Periodical Directory) and be less than five (5) years old.